摘要
目的分析胸腔镜辅助超声引导下房间隔缺损经胸封堵术的安全性和有效性。方法前瞻性分析2017年1～9月我院行胸腔镜辅助超声引导下经胸房间隔缺损封堵术12例患者的临床资料,其中男4例、女8例,年龄29(24.5～39.5)岁。研究其房间隔缺损病变特征、术中操作特点、手术安全性和有效性、术后并发症及随访结果。结果 12例患者中有10例成功行胸腔镜辅助超声引导下房间隔缺损封堵术,2例中转胸腔镜辅助体外循环下房间隔缺损修补术。成功行经胸封堵的患者缺损大小17～40(27.22±8.97)mm,使用的封堵器大小36(30～42)mm,术后平均住院时间6 d,术后无明显心率失常、出血、心包积液等并发症。术后平均随访6(3～10)个月。随访期间未见Ⅲ度传导阻滞,无封堵器脱落、无残余分流、无心包积液。结论胸腔镜辅助超声引导下房间隔缺损经胸封堵术是一种微创、安全、有效的治疗方法。为缺损直径较大、缺损边缘条件差的患者提供了一种全新微创的手术选择。
Objective To analyze the safety and effectiveness of ultrasound-guided thoracoscopic atrial septal defect （ASD） closure. Methods We prospectively collected the clinical data of 12 patients with ASD treated by ultrasound-guided thoracoscopic ASD closure in Fuwai Hospital from January to September 2017. The characteristics of the patients＇ ASD and operation, operation safety and effectiveness, postoperative complications and follow-up results were analyzed. Results Among the 12 patients, 10 were successfully treated with ultrasound-guided thoracoscopic ASD closure. Two patients switched to ASD repair under thoracoscopy-assisted cardiopulmonary bypass. The size of the ASD was 17-40 （27.22±8.97） mm and the size of the occluder was 36 （30-42） mm. The average postoperative length of hospital stay was 6 days. There were no complications such as arrhythmia, bleeding and pericardial effusion after operation. The average follow-up was 6 （3-10） months after the operation. During the follow-up, no III-degree conduction block, occluder dislocation, residual shunt or cardiac pericardial effusion was found. Conclusion Ultrasound-guided thoracoscopic ASD closure is a minimally invasive, safe and effective treatment. This technique provides a new minimally invasive surgical option for patients with large defect diameter and poor edge condition.
作者
龚丁旭
郑哲
赵广智
谢涌泉
张凤文
潘湘斌
GONG Dingxu;ZHENG Zhe;ZHAO Guangzhi;XIE Yongquan;ZHANG Fengwen;PAN Xiangbin(Department of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2018年第6期462-465,共4页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
国家自然科学基金青年科学基金项目(81400041)
关键词
房间隔缺损
胸腔镜
超声介入
经胸封堵
Atrial septal defect
thoracoscopy
ultrasound-guided intervention
transcatheter closure
